Automated portable medication radial dispensing apparatus and method using a carrier tape

ABSTRACT

A portable medication cartridge allows for both manual and automated dispensing of tablets or capsules of virtually all sizes through a radial dispensing apparatus. The cartridge may be sealed and encoded with medication and patient identification. A microprocessor controlled medication dispensing apparatus includes a cartridge magazine capable of holding a plurality of cartridges for the same or different patients. The portable medication dispensing apparatus and method detects patient identification data and activates a radial dispensing medication cartridge in response to verification of patient identification data. The radial dispensing medication cartridge may include, for example, a tablet carrier tape having a plurality of tablet packets with at least a partially open side. The tablet carrier tape accommodates different sizes and types of tablets or capsules and is sealed with a cover tape having an identification of the tablets. The cover tape is removed after the carrier tape is inserted into the dispensing medication cartridge. The medication is sequentially advanced and allowed to radially dispense through the open side of the tablet carrier tape from the medication cartridge.

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation-in-part application of Ser.No. 09/280,109, filed Mar. 26, 1999.

FIELD OF THE INVENTION

[0002] The invention relates generally to systems and methods forfacilitating patient prescription compliance and for dispensingmedication and more particularly to portable medical dispensingapparatus and methods with patient compliance control.

BACKGROUND OF THE INVENTION

[0003] Patient non-adherence to prescribed medication regimens is high,with non-adherence rates among geriatric patients ranging 40-75%according to several studies. Multiple factors contribute tonon-adherence including visual, auditory, and cognitive impairments, aswell as poly-pharmacy, poly-providers, and visit and refill compliance.Drugs not taken, or taken incorrectly incur the same healthcare costs asfully adherent regimens, but without the expected medical outcome. Onerecent study reported that non-adherence to medication regimensaccounted for 18% of hospitalizations in the elderly. In addition to theneeds of the elderly, the identification and documentation requirementsfor medication administration in schools, workplaces and assisted livingfacilities have increased. As such, many attempts have been made toprovide prescription reminder systems and methods as well as medicationdelivery systems for patients who may benefit from monitored medicationdispensing. For example, systems are known which provide patients withalert devices to remind patients of when to take medication, and howmuch medication to take. In addition, there are various systems thatprotect patients from overdosage and underdosage and attempt to improvepatient compliance using such devices as unit dose containers, timingmechanisms, and sensors to detect patient use. These interventions mayrequire labor-intensive filling and monitoring as well as on-sitereprogramming to allow for interval changes in medical regimen. Positiveidentification of the medication in the dispensing unit from pharmacy topoint of use would be more desirable.

[0004] A preferred system would also include patient identificationinformation that may be read by a medication dispensing unit orprovider. The medication-dispensing unit may then dispense theappropriate allowance of medication to the matched recipient at anappropriate time under microprocessor control. Such dispensing unitscould be remote from a main unit of a health care provider, such as aphysician, hospital or other health care provider. The health careprovider may communicate with the patient through the dispensing unit toprovide prescription information, drug interaction information, dosingchange and other feedback as desired. The software programs to providesuch control exist in the public domain, and have been used byinstitutions to monitor safety and compliance. However, the dispensingunits employed are geared to high volume institutional use.

[0005] Prior home dispensing systems typically are not readily portable,and do not provide a relative cost effective and easy mechanism todispense medication. Filling and refilling may require in-homeassistance. Transfer of medication from a pharmacy or provider-labeledcontainers may be required, introducing the possibility of medicationidentification errors. Also, conventional systems do not match theidentities of the prescriptions to the patient. For example, they do nottypically verify that the patient receiving the medication is thesuitable recipient of the prescribed medication. Consequently, thereexists a need for an improved portable medication dispensing apparatusand method.

BRIEF DESCRIPTION OF THE DRAWINGS

[0006]FIG. 1 is a block diagram illustrating one example a radialmedication dispensing device with remote monitoring and access controlin accordance with one embodiment of the invention.

[0007]FIG. 2 is a block diagram illustrating one ex ample of a radialmedication dispensing device with remote monitoring and access controlin accordance with one embodiment of the invention.

[0008]FIG. 3 is a perspective view of one example of a radial dispensingmedication cartridge in accordance with one embodiment of the invention.

[0009]FIG. 4 is an assembly viewer of one example of a radial dispensingmedication cartridge in accordance with one embodiment of the invention.

[0010]FIG. 5 is a perspective view of the radial dispensing medicationcartridge of FIG. 3 with the cover closed.

[0011]FIG. 6a is a cross-sectional view of the radial dispensingmedication cartridge of FIG. 5.

[0012]FIG. 6b is a cutaway partial cross-sectional view showinginteracting teeth for the cartridge in accordance with one embodiment ofthe invention.

[0013]FIG. 7a is an illustration of an example of a tablet stall insertand an associated tablet tray in accordance with one embodiment of theinvention.

[0014]FIG. 7b is a cross-sectional view of the tablet stall insert,inserted into the tablet tray shown in FIG. 7a.

[0015]FIG. 8 is a perspective view of a medication dispensing apparatusin accordance with one embodiment of the invention having a slopedmedication cartridge magazine and an angled tablet chute in accordancewith one embodiment of the invention.

[0016]FIG. 9 is a cross-sectional view illustrating an actuator andassociated rotating member of a radial dispensing medication cartridgein accordance with one embodiment of the invention.

[0017]FIG. 10 is a flow chart illustrating one embodiment of theoperation of the medication dispensing apparatus illustrated in FIGS. 2and 8 in accordance with one embodiment of the invention.

[0018]FIG. 11 is a flow chart illustrating the operations that may takeplace, for example, with a provider to fill and suitably provide atablet tray in accordance with one embodiment of the invention.

[0019]FIGS. 12a and 12 b are graphic representations of examples ofcartridge bar code data and cartridge patient prescription-specific datathat may be placed on a cartridge in accordance with one embodiment ofthe invention.

[0020]FIG. 12c is a graphic representation of an example of patient datathat may be used to verify that the correct patient is receiving themedication.

[0021]FIG. 13 is a perspective view of a carrier tape used according tothe present invention.

[0022]FIG. 14 is a top view of the FIG. 13 carrier tape.

[0023]FIG. 15 is a perspective view of the carrier tape which has beenformed into a loop.

[0024]FIG. 16 is a cross sectional view of a detail of the carrier tapedepicted in FIG. 15 with space limiting insert.

[0025]FIG. 17 is a perspective view of the carrier tape loop showinginstallation on a rotational member.

[0026]FIG. 18 depicts a housing for the carrier tape and rotationalmember.

[0027]FIG. 19 is a perspective view showing the rotational member andcarrier tape installed in the FIG. 18 housing.

[0028]FIG. 20 is a perspective view of the closed housing according tothe present invention.

[0029]FIG. 21 is a cutaway prospective view of a detail of the base ofthe housing and the rotational member according to the presentinvention.

[0030]FIG. 22a is a prospective view of a medical dispensing device withinstalled cartridges according to the present invention.

[0031]FIG. 22b is a cross sectional view of the FIG. 22a medicaldispensing device.

[0032]FIG. 23 is a cross sectional view depicting the engagement of therotational member with the carrier tape for proper registration.

[0033]FIG. 24 depicts another embodiment of the engagement of therotational member with the carrier tape for proper registration.

[0034]FIG. 25 is a general flow chart depicting the overall process ofreceiving a prescription and ultimately sending it to the patientaccording to the present invention.

[0035]FIG. 26 is a general flow chart which depicts dispensingmedication in the medical dispensing device according to the presentinvention.

[0036]FIG. 27 is a logic diagram depicting operation of a medicationdispensing device.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT OF THE INVENTION

[0037] Briefly, a portable medication cartridge allows for both manualand automated dispensing of tablets or capsules of virtually all sizesthrough a radial dispensing apparatus. The cartridge may be sealed andencoded with medication and patient identification. A microprocessorcontrolled medication dispensing apparatus includes a cartridge magazinecapable of holding a plurality of cartridges for the same or differentpatients. The portable medication dispensing apparatus and methoddetects patient identification data and activates a radial dispensingmedication cartridge in response to verification of patientidentification data. The radial dispensing medication cartridge mayinclude, for example, a tablet tray having, a plurality of tablet stallswith at least a partially open top and side. The tablet and trayaccommodates different sizes and types of tablets or capsules. Atemporary tablet retention band is removably attached to the table trayto keep the tablets tray from exiting the open side of the tray untilthe tablet tray is suitably filled and later inserted into thedispensing medication cartridge. In one embodiment, the radialdispensing medication cartridge includes a rotational tablet dispenseradapted for rotational advancement of medication, such as tablets, andradial dispensing of the medication from the cartridge. The removabletablet retention band is extracted after the table tray is properlyinserted into the medication cartridge. The medication is sequentiallyadvanced and allowed to radially dispense through an open side of thetablet tray from the medication cartridge.

[0038] In one embodiment, the medication dispensing apparatus includes aradial dispensing medication cartridge magazine that holds a pluralityof medication cartridges to accommodate differing medications orpatients. The medication dispensing apparatus includes a suitableprocessing device and remote interface to allow a provider to directlycommunicate with the apparatus and allow the patient to provideinformation or respond to questions through a keypad speaker or othersuitable interface. In addition, the processor controls dispensing ofmedication from the radial dispensing medication cartridge at anappropriate time and in appropriate amounts based on eitherpreprogrammed timing information, information communicated remotely tothe device, or from a patient identification device such as a bar codedwrist band, encoded card or other suitable patient identificationmechanism. The device may also communicate with patient wearable alertmechanisms such as wrist watches or pagers.

[0039] In one embodiment, the radial dispensing medication cartridgemagazine is downwardly sloped along with an associated angled tabletchute so that the radially dispensed tablets travel down the chute andsubsequently to a common tray where the tablets may be extracted forconsumption. The tray may be removable with a plurality ofelectronically identified compartments to hold a day's medication. Aprocessor actuates one or more radial dispensing medication cartridges.If desired, dispensing may be controlled remotely by a caregiver througha remote communication interface. The remote communication interface mayinclude, for example, a bar code reader that may read both a bar code ona patient bracelet and also read bar code medication information on eachcartridge so that the system can determine the type of medication withineach cartridge and confirm the identity of the patient. The medicationbarcode data on the cartridge also preferably includes dosage andfrequency data that is read by the processor and provides medicationspecific administration criteria to be communicated to the device toaccommodate variances in administration schedules.

[0040] In one embodiment, the radial dispensing medication cartridgeincludes a manual activation surface, such as a knob or other surface,to facilitate manual radial dispensing of medication from the cartridgewhen the cartridge is removed from the magazine. The radial dispensingmedication cartridge may also include a separate surface adapted toengage with an actuator during automated radial dispensing of medicationin the cartridge when the cartridge is in the magazine.

[0041] Compliance is monitored through sensors located in the magazineat each cartridge location and in the patient extraction tray. Thedevice's medication administration criteria are reset when the sensorsare activated at both locations. Alternatively, or in addition, camerascan be used to verify medication consumption.

[0042]FIG. 1 is a block diagram showing a medication dispensing andcompliance system 10 having a radial medical dispensing device 12 thatreceives patient verification information 14 from a patient verificationdevice 16. A medical communication infrastructure 18 may communicateover a suitable communication link 20 with the radial medicationdispensing device 12.

[0043] The radial medication dispensing device may have, for example,remote monitoring capabilities to allow healthcare providers orcomputers 18 to monitor information on patient medication compliance ornoncompliance as well as control medication access. This allows, forexample, a remote caregiver to adjust or cancel a medication regimen.

[0044] The medical communication infrastructure 18 may be simply anursing station, or a more complex medical infrastructure that mayinclude integrated order entry, results retrieval and pharmacymanagement components. For example, the medical communicationinfrastructure 18 may be the Veterans Administration Health InformationSystem and Technology Architecture (VISTA). The architecture andfeatures of such a system may be obtained for example from HinesHospital Veterans Administration, FOIA Office, Hines, Ill. As such, apharmacist at a pharmacy, a doctor, computer or other personnel maycommunicate with the patient through a speaker, display or othersuitable mechanism to either provide additional information, receivefeedback information from the patient, from the radial medicationdispensing device or provide instructions dosage or any other suitableinformation from a remote location.

[0045] The patient verification device may be any suitable mechanism (ormechanisms) that provides some patent verification information 14, suchas a patient's name, social security number, or a prescription number,in a manner to match data on a bar-coded on the medication cartridges.The radial medication dispensing device 12 then confirms that the personaccessing the machine is the patient. For example, the patientverification device may include a bracelet with a bar code, a watch withan infrared communication link, a smartcard, or any other suitablemechanism that can provide requisite patient identification information.

[0046]FIG. 2 shows an embodiment of the medication dispensing andcompliance system 10 that employs a radial medication dispensing device12 having a data processor 30 operatively coupled to an informationtransmitter and/or receiver 32, a modem 34 or other communicationinterface device, a camera 36 and a medical information display 38, suchas an LCD display or other suitable display device. The processor 30 isalso operatively coupled to the patient verification device 16 which maybe, for example, a bar code reader for a radial dispenser and/or a barcode reader for a patient identification bar code. The data processor 30is also operatively coupled to control one or more radial dispenseractuators 40 that may be part of the radial dispenser. The dataprocessor 30 also receives pill dispensing detection data 42 such aswhether tablets have been suitably dispensed, from a cartridge tabletsensing system 34 and verify that they have been removed though sensorsin the receiving tray. The data processor 30 may also receive control ormedication information 46 from an international or other standardizedmedication database such as the International Pharmaceutical Bar CodeAssociation database and the National Patient Medication Informationsoftware or local pharmacy software which provides drug interactioninformation as well as patient information to the data processor. Themedication information source 48 may also be suitably coupled to themodem 34 or to any other suitable connection to provide the dataprocessor 30 with the requisite medical information required by theradial medication dispensing system.

[0047] The data processor 00 may be any suitable microprocessor,microcontroller, logic, state machine or other suitable circuit that mayemploy software control or hardware control or a suitable combinationthereof to facilitate the dispensing of medication from the radialdispensing device. The transmitter and/or receiver 32 may be a pager,audio alarm, speaker or any other suitable device that may receive apatient's voice or transmit a caregiver's voice or other information tofacilitate compliance, monitoring, emergency information or any othersuitable information as required. The modem 34 provides an interfacebetween the medical communication infrastructure 18 and the dataprocessor 30 so that suitable information can also be communicated.Communication may occur over any suitable communication link 20 whichmay be, for example, a network link, a wireless communication link,telephone line or landline communication or other suitable link.

[0048] The camera 36 may be any suitable camera that may be located, forexample, in the patient's home or office through which video information50 is passed from the camera through the modem or to the data processor30 as feedback information so that a caregiver can monitor exactly howthe radial dispensing apparatus is being used, or can visually view themedication being removed from the tray or any other suitable monitoring,if desired. The medical information display 38 displays, for example,medical information relating to the medication in the radial dispensingapparatus. For example the medical information that may be displayed bythe data processor may include information relating to the dosage,conditions for administration (fasting, with water, etc.) informationsent by a medical communication infrastructure 18 indicating druginteraction information or any other suitable information including, forexample, refill alerts and instructions, or visit reminders. The dataprocessor 30 communicates with the transmitter/receiver 3′, the modem34, the camera 36 and the medical information display 30 through acombination of suitable busses or links generally indicated at 52.

[0049] The medical communication infrastructure 18 may include, forexample, a General Interface Manager 54 to access multiple programs at anumber of sites or a dedicated medication protocol computer 56, such asa Warfarin Adjustment protocol medical computer as known in the art thatis used to change prescriptions so that the dosages or medicationdispensed by the radial dispenser are changed on a per cartridge basisand per patient basis, if desired. The databases may include, forexample, international pharmaceutical bar codes, drug identification andinteraction allergy tracking, drug administration criteria (dosage,etc.) and patient medical information indexed by patient ID. Thephysiofeedback data 58 are, for example, blood pressure, weight, glucoselevels, protimes from the patient, that also may be coupled andcommunicated through the data processor 30 or any other suitableinformation that may be used by a caregiver to determine whether apatient's reaction to the medication is within acceptable parameters. Assuch, a blood pressure monitor, scale or other suitable physiodataprovider is operatively coupled to the processor 30. Keypad entry mayalso be used to enter queries or data.

[0050]FIG. 3 illustrates one example of a radial dispensing cartridge100 that includes a housing 102 having a base 104, a cover 106, a tablettray 108 and a rotational member 110. In this embodiment, the housing102 is configured as a box-like housing with a hinge arrangement forcoupling the base 104 with the cover 106. For example, the cover 106 ishingedly attached to the base 104 through protrusions in correspondingdetents indicated generally at 112 a and 112 b. However, it will berecognized that any suitable coupling of the base to the cover may beused. Also, the hinge may also be coupled to another side of the base.

[0051] The housing 102 may be made from plastic or any other suitablematerials. The cover 106 has an inner surface 114 from which a tabletretaining wall 116 protrudes. Tablet retaining wall 116 projectsgenerally upwardly from an inside surface of the cover 106 when thecover is open as shown. The tablet retaining wall 116 may be a circularretaining wall or any other suitable shape that retains tablets within atablet tray 108 when the cover 106 is closed. The tablet retaining wall116 includes an opening 118 through which tablets are radiallydispensed. In this embodiment, the tablet retaining wall is integrallymolded as part of the cover 106. The cover 106 also includes, ifdesired, an aperture 120 through which a manual activation surface mayprotrude to allow manual tablet dispensing.

[0052] The cover 106 may also include patient identification data 122 bsuch as a bar code label or other mechanism that contains, for example,the name of the patient, the type of medication in the cartridge, theprescription, or any other suitable information. In this example, thebar code label includes identifying data from the InternationalPharmaceutical Bar Code Association database. Also, in this embodiment,the patient identification data 122 b or other suitable data is placedon an outer surface of the housing 102. The patient identification data122 b, shown in the form of a bar code label, is placed on an end 124 ofthe housing 102 wherein the end is part of the cover 106 (in thisexample on the hinge mechanism). However, it will be recognized that thepatient identification data 122 b in its various forms may be placed atany suitable location on the medication cartridge which allows a datareader to obtain the information for use in properly identifying amedication user and for dispensing medication as described below.

[0053] Referring to FIGS. 3 and 4, the base 104 of the medicationdispensing cartridge 100 includes a support surface 130, a top sidewall132 a, sidewall 132 b and bottom sidewall 132 c. The support surface 130is a substantially flat member which serves to carry and support thetablet tray 108 and rotating member 110.

[0054] Located substantially centrally on flat support surface 130 is araised hub 140. Hub 140 has a generally cylindrical configuration and inaxis instance may have eight spoke-like elements forming a ring aboutits circumference. Four of these spokes are support spokes 142 whichextend generally vertically from flat support surface 130 to the raisedupper portion 144 of hub 140 so that the hub is essentially upstandingon four legs. Projecting generally downwardly from upper portion 144 andspaced alternately between support spokes 142 are four resilient,spring-like spokes 146 which do not extend completely down to the flatinner surface 132. A small spherically shaped protuberance 148 islocated in a lower end of resilient spokes 146 and cooperates withresilient spokes 146 to provide an attachment for rotating member 110 tothe support surface 130.

[0055] An optional pointer 150 is located on the flat upper portion 144of the hub, the pointer being molded integrally with the hub foreconomies of manufacture. In this instance, the pointer 150 points alongthe latitudinal axis of surface 130 but may be designed to point inother directions when desirable. In addition, other mechanisms todesignate to the user Which tablet is to be taken may be employed. Thepointer 150 may be used, for example, when the medication dispensingcartridge 100 is used as a manual dispensing device. Support 130 alsoincludes an annular ridge 154 spaced a short distance from hub 140 andsurrounding the hub. The ridge 154 is a small protuberance or projectingring integrally formed in a flat portion of the support 130 and servesto locate and position the rotating member 110 when attached to the base104.

[0056] A first set of ratchet teeth 158 upstands from the supportsurface 130. The set includes an array of teeth, there being the samenumber of teeth 158 to correspond with the number of tablets included inthe tablet tray 108. Accordingly, the number of ratchet teeth may varyaccording to the design and purpose of the tablet tray. As currentlystructured, the radial dispensing cartridge individually radiallydispenses one tablet at a time. For individual dispensing purposes, thenumber of ratchet teeth 158 will thus correspond with the number oftablets. Each tooth 158 is essentially an elongated raised protuberanceon the surface of the support 130, and includes an inclined edge whichforms an angle with respect to the flea portion of the support. Asillustrated, the teeth 18 are intermittently spaced in a circularlyoriented array. The ratchet mechanism and hub may be of a similar designdescribed in U.S. Pat. No. 4,165,709 entitled “Tablet Dispenser” issuedto John A. Studer Aug. 28, 1979.

[0057] The base 104 also includes a slot 160 wherein at least a portionof the rotating member 110 extends through the slot 160 to exposeengageable surfaces to an actuating member. The engageable surfaces inthis embodiment, are shown as surfaces 164 which may be shaped as gearteeth. A slot 160 is configured in sidewall 132 b to receive a portionof the rotating member, namely the engageable surfaces. Top sidewall 132b is opposite to the hinge. The bottom sidewall 132 c includes a singletablet dispensing aperture 170. The tablet dispensing aperture 170 issubstantially rectangularly shaped and extends completely through thebottom sidewall 132 c. In this embodiment, the tablet dispensingaperture 170 is also located with respect to the pointer 150 so that thepointer directly points to the aperture 170.

[0058] The tablet tray 108 and rotating member 110 make tip a rotationaltablet dispenser adapted for rotational advancement of medication andradial dispensing of medication from the cartridge. The tablet tray 108includes a plurality of tablet stalls 180 that have at least a partiallyopen top and a side. The tablet stalls 180 house tablets 182. The numberof tablet stalls 180 corresponds in this embodiment to the number ofteeth 158. The tablet tray 108 is a ring-shaped tablet tray having aremovable tablet retention band 184 which temporarily closes the opensides of the stalls. The removable tablet retention band 184 may beoperatively coupled to a base 186 of the tablet tray by perforation orother suitable removable attachment mechanism. During filling orrefilling of the tablet stalls, the removable tablet retention bandprevents tablets from exiting the open side of the stall. Each of thetablet stalls 180 has a back wall 190 to prevent the tablets fromfalling out of the stalls. The tablet tray 108 includes a substantiallycentrally located hole 192 extending therethrough. The hole 192 is sizedto fit over hub 150. The front side of the stalls that are open andtemporarily closed by the removable tablet retention band are locatedabout the circumference of the tablet tray 108. Each open front side isspaced along a radius from center point of the tray. The open sideopening is arranged to individually align in registration with bottomwall aperture 170 when the tray is attached to a surface of the rotatingmember 110 and rotating member 110 is then placed in cooperation withthe base 104.

[0059] The rotating member 110 includes a plurality of protrusions 196that in this embodiment are spared at approximately 120° apart may beintegrally molded from plastic if desired. The protrusions 196 extendthrough corresponding openings 198 in the tablet tray 108 to affix thetablet tray to the rotating member. The rotating member 110, in additionto including the engageable surfaces 164 to engage with an actuatingmember for automated radial dispensing tablets, also includes a manualactivation surface 200 to facilitate manual radial dispensing ofmedication from the cartridge. In this embodiment, the manual activationsurface 200 is a knob or other surface, such as an upraised annularsurface, which is sized to receive the tablet tray 108 through hole 192.The annular portion has a substantially flat upper face 202 which isupraised to lie at a height above the cover 106 when the cover is closed(see, for example. FIG. 4). Similarly, the hub 150 is also protruding toextend above an outer surface of the cover when the cover 106 is closed.The upraised annular portion has a substantially U-shaped cross section,thereby forming a hollow portion between the upstanding legs whichextend vertically downward to support fiat surface 202. Immediatelysurrounding the hole 102 is an annular phalange 208 (FIG. 6) whichserves as a short, circular lip to provide a mechanism of connectionbetween the support 130 and the rotating member 110. Located on flatsupper surface 202 is a plurality of indicators of periodicity 212. Theindicators may be applied onto the member using stickers to allow fordifferent schedules. As one example, the indicators may be abbreviationsof the days of the week and each indicator day is referenced to a tabletin the tablet tray. Being affixed to the upper face of the annularportion of the rotating member, indicators 212 thereby rotate with therotating member when rotation occurs. It will be understood that avariety of other information may be chosen, depending upon the type oftablets to be dispensed, and the rate to be taken.

[0060] The rotational member 110 as configured in this embodiment is agear having the plurality of actuation surfaces 164 configured to engagean actuation device to rotationally advance medication in the cartridge.The actuation surfaces in this embodiment are teeth. When assembled, thebase 104, which includes the plurality of ratchet protrusions or teeth158, are operatively engageable with the rotating member 110 to restrictrotational movement to facilitate single dose radial dispensing oftablets wherein the radial dispensing is out the bottom side wallthrough aperture 170.

[0061] The tablet tray 108 may be suitably made from a variety ofmaterials including plastic and other conventional material used topackage tablets. For example, suitable material that may be used to makethe ring tablet trays may be the materials used by Ortho PharmaceuticalCorporation, Raretan, N.J. to make tablet trays disclosed in U.S. Pat.No. 4,165,709. This may be, for example, blister pack or blister sheet.The blister pack is made of a thin plastic or other easily formablematerial which has been formed into a plurality of tablet stalls. Thetablet stalls are arranged in a circular orientation and substantiallyequally spaced apart to correspond with the teeth 158. Each stall isshaped and sized so as to enable commonly sized and shaped tablets orother solid form of pharmaceutical preparations to fit therein. It hasbeen found that one suitable stall dimension may be height={fraction(9/16)}″, width=0.375″ and depth=⅞″. The base 180 and removable tabletretention band 184 may be made of a frangible membrane such as a thinsheet of material such as foil or the like.

[0062] The tablet tray 108 is operatively removable from the cartridgehousing so that refills or other tablet trays can suitably be installed.The filling of the tablet trays 108 may be done, for example, by apharmacy, tablet manufacturer or other tablet source either by a manualor an automated system. The open top of the stalls allows placement ofthe pills within the tablet tray 108. In one embodiment, each cartridgecontains a single drug for a single patient. Once the tablet tray 108 isfilled with the appropriate tablets, a stall top cover member 220 isplaced over the top of the stalls to keep the tablets in theirrespective stalls during transportation. The stall top cover member 220may be a flat ring shaped cap to correspond to the ring shape of thetablet tray and may be a nonadhesive cap or an adhesive-based cap, ifdesired. (For purposes of illustration, the stall top cover is not shownin FIG. 3). The stall top cover member may also be a flat sheet or anyother suitable cover member adapted to cover the stalls.

[0063] As shown, the tablet stalls 180 are positioned along theperiphery of the trays and are sized to hold a single tablet. The tablettray 108 with stall top cover member 220 is aligned into position withthe rotating member 110 through the apertures 198. The cover 106 is thenclosed whereafter the removable tablet retention band 170 is removed tofacilitate removal, the removable table retention band 170 includes anextension portion 222. The extension portion 222 is placed through theaperture 170 so that it may be readily gripped by fingers or otherdevice. The removable tablet retention 170 band is removably fixed to asurface (e.g. base) of the tablet tray 108 such that it may be removedwhile the cover is closed. The removable retention band 170 should besized and temporarily attached such that pulling the removable retentionband 170 causes the rotating member to rotate and disconnection of theband 170 from the tray. Removing the tablet retention band 170 thenexposes the open sides of the stalls. To avoid undesired tablet wasteduring band 170 removal, one stall may be kept empty. The permanenttablet retention ring 116 in the cover surrounds the removable retentionband 170, so that during and after removal the retention ring 116 servesto effectively close the open ends except for the stall which is placedin position with the aperture 170 to dispense a tablet. As such, thetablet tray 108 may be suitably transported and filled in a advantageousmanner. The tablet tray 108 is a unitary structure in itself whichprovides easy handleability for placement of the tray into the dispenserand subsequently easy removal upon exhaustion of the tablet supply.

[0064] On an undersurface of rotating member 110, the surface facingflat support surface 130, there is a second set of ratchet teeth 230FIG. 6b. In this instance there are only three ratchet teeth in the setand they are spaced substantially equal a part and circularly located ona radius which is substantially the same as the radius of location ofthe first set of ratchet teeth 158 on the support surface 130. Ratchetteeth 230 include an inclined edge thereon and project from the rotatingmember 110 to oppose the first set of ratchet teeth in the support.Thus, the two sets of ratchet teeth 230 and 158 are adapted to becomeintermittently engaged with each other to thereby allow incrementalrotation of the tray and the support in only one rotative direction, notthe other. This rotation is accomplished by the orientation of theincline surfaces in the vertical wall in each tooth directly oppositethe incline surface. Such a mechanism is further disclosed, for example,in U.S. Pat. No. 4,165,709 incorporated herein by reference.

[0065] Referring to FIG. 5, the cover of the magazine is closed toenclose the tablet tray within the base. The manual activation surfaceis exposed above the top of the cover to allow manual activation ofradial tablet dispensing out aperture 170. As shown, the aperture 170 isthe only aperture through which medication may be dispensed.

[0066] Referring to FIGS. 7a and 7 b, a matable stall insert 300 isshown having tablet stalls of a size smaller than the tablet stalls ofthe tablet tray 108. The matable stall insert 130 may contain, forexample, smaller tablets. The matable stall insert 300 is operative tomate with the table stalls 180 so that the common size base tablet tray108, can be fabricated along with differing sized stall inserts 300 toaccommodate different size pills, such as smaller pills. As seen in FIG.7b, also, the matable stall insert 300 includes a removable tabletretention band 302 projecting downward along a periphery of the insertto temporarily close open sides of the tablet stalls 304. As indicated,tablet stalls 304 have a base wall and rear wall and corresponding sidewalls but the top of the stall and the front side of the stall are openprior to the removable retention band being applied and prior to a stalltop cove 306 being applied. The removable tablet retention band may beremovably attached to a surface of the insert 300 through perforations.

[0067] Referring to FIG. 8, a medication dispensing apparatus 10 isshown having a medication cartridge magazine 400 adapted to hold aplurality of radial dispensing medication cartridges 100 a-100 n. Thedevice includes an enclosure 402 that houses the cartridge magazine 400along with the requisite components of FIG. 2. As shown, the cartridgemagazine 400 holds the plurality of the radial dispensing medicationcartridges 100 a-100 n on edge and adjacent to one another to facilitatecompactness and portability. The patient identification data 122 ismachine readable medication identification data. Also, referring to FIG.9 the plurality of radial dispensing medication cartridges 100 a-100 nradially dispense tablets downwardly through their respective apertures170 into a common sloped tablet chute 406. Sloped tablet chute 406 has across-sectional “V” shape and directs radially dispensed tablets to acommon receptacle 408 which contains all of the medication for aparticular dosage. The sloped table chute may, be sloped at an angle ofapproximately 45. However, any suitable slope may also be used. FIG. 8represents, for example, a cross-sectional side view of apparatus 10through its housing 402. The sloped cartridge magazine 400 is suitablyaffixed to a frame within the housing and is adapted to hold theplurality of radial dispensing, medication cartridges. The slopedcartridge magazine is sloped at about 45°. The sloped tablet receivingchute 406 is operatively located to receive tablets that are radiallydispensed from the plurality of cartridges. Each of the plurality ofcartridges 100 a-100 n as indicated includes an opening 170 thereinthrough which an individual tablet is radially dispensed in response toactuation by an actuating mechanism 410. In this embodiment, theactuating mechanism 410 includes a separate actuator 412 associated witheach of the plurality of radial dispensing medication cartridges 100a-100 n. As such the system 10 includes actuators 412 a-412 n. Eachactuator 412 suitably engages the actuation surface of each of therotational members to rotationally advance medication in the cartridgeand regularly dispense the tablet vertically. The actuators 412 a-412 nmay be, for example, electrically activated solenoids and associatedactivating members 413. Here the actuating members 413 are “L” shapedpivoting members suitably biased to operatively advance the rotationalmember to radially drop or expel one tablet at a time by being pushedforward by the solenoid and retracting after the rotating member hasrotated. However, any suitable activating structure may be used, such asa direct action reciprocating solenoid, a series of linkages or othersuitable mechanism. The common receptacle 408 may include a cover (notshown) which may provide a feedback signal to the data processor 30 toindicate whether medication has been removed from the common receptacle408. If desired, the common receptacle 408 may also be configured as aplurality of separate receiving compartments wherein each compartment isdedicated to receive tablets from each of a separate cartridge 122.

[0068] Compliance detection is accomplished through the use of aplurality of sensors. In this embodiment, an array of electrodes orwires shown in cross-section as 409 a-409 m serve as one type of percartridge based sensing device. The sensor uses a capacitance basedarrays wherein capacitance is generated by the wires so that when atablet drops from any of the cartridges, the change in capacitancebetween lines is detected by the processor 30. Depending upon whichcapacitance field is varied by the dropping of the tablet, the processordetermines which cartridge radially dispensed the tablet. In addition tothe per cartridge based sensor, a tray sensor 411, such as anothercapacitance based sensor, is placed in the receiving tray. Suitablewires are positioned to create another field and may be broken byfingers or other protruding elements that break or vary the capacitivefield to obtain the tablets. As such, if the processor determines that atablet has been dropped in accordance with a regimen, but that thesensor 411 has not detected that the tablet or tablets have beenremoved, the medical data bases may be reviewed to determine whether thenext dosage needs to be modified and may also generate a display to thepatient or a beep for the patient indicating that the medication hasbeen dispensed.

[0069] Referring to FIGS. 2, 8 and 9, medication dispensing apparatus 10uses a patient verification device, such as processor 30, operative toactivate the radial dispensing medication cartridge in response toverification of patient identification data. The medication dispensingapparatus 10, as previously noted, includes the remote communicationinterface 34 as well as the data processor 30 that is operativelycoupled to the radial tablet dispensing actuator 412, the patientverification device, such as the processor 30, and to the remotecommunication interface.

[0070] Each of the plurality of radial dispensing medication cartridges100 a-10 n includes medication identification data 122, such as bar codedata containing medication identification data and patientidentification data. Medication identification data 122 may include, forexample, the type of medication in a given cartridge along with itsdosage requirements as well as patient identification data indicatingthe name and other patient identification information to ensure that themedication from the appropriate cartridges are being used for the properpatient. As such, the medication identification data 122 on differentcartridges may be for different patients although housed in the samemagazine.

[0071] The housing 402 includes a bar code reader 420 positioned to readthe bar code data 122. The housing also includes a window 422. The barcode reader 420 is positioned to read the bar code data 122 on eachcartridge and also to read the bar code data located outside thehousing, such as bar code data on a patients wrist band, for example.The system then reads the bar code information on the patients wristband prior to dispensing medication. The system, through the dataprocessor, compares the patient identification data from the patient'swrist band or verification card with the stored bar code informationfrom the cartridges and confirms that the patient and cartridge aredesignated for each other and the processor suitably activates eachappropriate solenoid the dispense the appropriate dosage of medication.As such, the processor receives patient identification data and alsoobtains patient identification data from the cartridge to serve as thepatient verification means. The processor obtains, for example, patientidentification data, medication identification data and dosage data fromthe plurality of radial dispensing medication cartridges when they arefirst inserted (and prior to each dispensing operation if desired) andsubsequently controls the radial tablet dispensing actuator 412 toradially dispense single tablets from one or more cartridges in responseto the obtained patient identification data, medication identificationdata and dosage data. The processor generates a control signal to theradial dispenser actuator (solenoid) either based on the comparison ofinformation from the patient's wrist band and corresponding bar code aswell as prestored dosage information that may have been communicated,for example, to the remote communication device, from a caregiver toindicate a change in dosage if the dosage information is not included onthe bar code information and on the cartridge.

[0072] Referring to FIGS. 10-12, the apparatus will activate the barcode reader to read the cartridge bar code data 122 a when a cartridgehas been placed in a magazine as detected by the bar cod reader or asindicated through a keypad by a patient. As shown in block 502, thesystem fetches the patient and drug information from the databases 18based on the read cartridge bar code data. As shown in block 504, thesystem determines whether the prescription information from the bar codedata matches the retrieved administration criteria data for theparticular drug. If the prescription information does not match theadministration criteria data, the system generates a patient or provideralert regarding the conflict as shown in block 506. For example, thesystem may display an error message to the patient or initiatecommunication with the remote provider to the modem. If the prescriptioninformation as read from the cartridge bar code matches theadministration criteria for the given drug, the system alerts thepatient to take medication as shown in block 508. This may be done, forexample, by paging the patient, emitting a sound through the speaker, orthrough other suitable notification mechanisms.

[0073] As shown in block 510, the system reads the patient ID data fromthe patient ID bracelet (e g, bar code on the bracelet) or other patientID source unique to the patient. The system then compares the readpatient to see whether the stored cartridge patient ID equals the readpatient ID as obtained from the patient bar code as shown in block 512.If the patient ID on the cartridge does not match the patient IDobtained from the bar code data on the patient's bracelet, the systemactivates an alarm and inhibits dispensing as shown in block 514. Asshown in block 516, if the stored cartridge bar code patient ID datamatches the read patient ID data from the patient's bracelet, the systemactivates the appropriate radial dispenser based on the prescriptiondata on the cartridge bar code as shown in block 516. As shown in block518, the system determines whether proper dispensing has occurred byevaluating the data from the capacitive sensors. If the appropriatedelivery sensors were activated indicating that a pill or pills weresuitably dispensed, the system determines if the patient withdrawalsensor located in the tray has been activated as shown in block 520. Ifboth the appropriate pill delivery sensors and the patient withdrawalsensor have been activated, the system resets regimen timers to begindispensing again according to the patient's regimen as stored in theprocessor shown in block 522.

[0074] However, as shown in block 524, if the appropriate deliverysensor did not activate, the system may determine if the cartridge isempty by checking a counter that counts the number of times that aparticular actuator for the cartridge had been activated since the lastcartridge refill to determine whether medication is still present in thecartridge. If the cartridge is determined not to be empty, the systemindicates that a malfunction has occurred and will generate an errornotice on the display device for the patient and/or the provider. Asshown in block 526, the processor may generate a patient messagerequesting that the patient remove the cartridge and actuate thecartridge manually to dispense a tablet. This manual dispensing mayoccur by turning the knob to force rotation of the rotating member.

[0075] Referring back to block 520, if the medication has been detectedas being dispensed from the proper cartridge but the patient withdrawalsensor has not been activated, the system will inhibit furtherdispensing as shown in block 528. As shown in block 530, the systemretrieves the stored interaction criteria from the suitable database todetermine the next dosage requirement for the drug-specific regimen andalters the dispensing based on the interaction criteria to facilitateautomatic dosage modification.

[0076] As shown in FIG. 11, the tablet trays and associated cartridgesmay be filled and processed as follows. As shown in block 600, a machineor other operator may fill the tablet stalls as shown in block 600 withthe desired medication and then apply the stall top seal. As shown inblock 602, a bar code generator generates the cartridge bar code data122 a, patient-specific bar code data 122 b, and patient ID bar codedata. As shown in block 604, a pharmacist or machine may apply thecartridge bar code data and patient specific bar code data to thecartridge. As shown in block 606, the patient identification bar codedata is applied to the patient bracelet or other medium to insure thatverification between the patient and the corresponding medication can beperformed by the processor.

[0077]FIGS. 12a-12 b represents one example of the cartridge bar codedata 122 a and the cartridge patient/prescription-specific data 122 b.As shown, the cartridge bar code data may be a bar code including, forexample, generic drug identification data, drug class information, lotnumber information, manufacture identification information the size andcolor of the tablets in the trays, and any other suitable information.Similarly the cartridge patient prescription specific data may be placedin the bar code and may contain patient ID data such as the name, socialsecurity number or other identifying information of the patient, orprescription identification data indicating for example, a prescriptionnumber instead of patient identification information. In addition, thecartridge patient/prescription specific data may include medicationprovider information such as the name of the tablet provider, such as apharmacy or manufacturer, the prescription (e.g., the physicianinstructions as to dosage, frequency etc. . . . ), any suitable pharmacyprovider internal control data, and any other suitable data.

[0078]FIG. 122c illustrates an example of patient verification data thatmay be located in barcode form or any suitable form on a patient IDcard, bracelet or other suitable mechanism. The data includes patientidentification data such as a name, unique number or other suitableidentification data. If the system is used to dispense medication formultiple patients, the identification data may be unique to at least oneof the cartridges. Also if desired, the patient data may includeexpiration data, that is used by the processor to stop dispensing whenthe expiration date is reached. This expiration data may also becompared to the expiration data included on the cartridge barcodes.

[0079] The present invention is also directed to a medication dispensingdevice in which a tablet carrier tape is utilized instead of the tablettray 108. Carrier tapes are known for use in packaging electroniccomponents. Numerous companies, such as ADVANTEK CORP., provide suchcarrier tapes for electronic components. Also, it is known to useblister packs (such as provided by Nektron, Incorporated) for pills andtablets. Furthermore, numerous companies manufacture and sell machineryfor filling carrier tape. V-tek, Incorporated and Argosy, Incorporatedare two companies that provide such machinery. In U.S. Pat. No.5,630,347 issued to Elvio, for a pharmaceutical dispenser for dispensinga variable and predetermined of tablets for similar products packaged ina blister strip, machinery is disclosed which dispenses a predeterminednumber of pills in a crimped blister pack strip from a supply reel. Thismachine, after counting the number of requested tablets, cuts off theblister strip and drops it into a deliverer tray.

[0080] The present invention provides a novel embodiment for a medicaldispenser which utilizes the carrier tape technology. As depicted inFIG. 13, the carrier tape 700 has a pluralist of pockets 702 and issealed by cover tape 704. Also as can be more clearly seen in FIG. 14,in the carrier tape 700 is a series of apertures 706 along an edge 708of the carrier tape 700. As will be explained below, these apertures 706function as registration apertures for indexing the carrier tape 700 inthe medication dispensing device.

[0081] Initially the carrier tape 700 is filled with pills or tablets ofmedication (hereinafter the term “tablet” will refer to all forms ofmedication, such as pills or tablets, and the pockets 702 of the carriertape 700 have been sealed with the cover tape 704 by means of a coldseal adhesive, a heat activated adhesive or a pressure sensitiveadhesive, for example. A predetermined length of the carrier tapes 700is then cut from a larger supply of the carrier tape 700 and is formedinto a loop attaching a first end 710 of the carrier tape 700 to asecond end 712 of the carrier tape 700. The first end 710 is connectedto the second end 712 by engaging a first pocket 14 on the first end 710with a last pocket 716 on the second end 712. This is depicted in FIG.15. Also in FIG. 16 a cross sectional view shoes that the last pocket716 engaged with the first pocket 714. It is to be noted that obviouslythe first pocket 714 must be empty such that the last pocket 716 withits respective tablet 718 can be inserted thereinto. Also as can be seenin FIG. 15, an identifier 720, such as a barcode, has been affixed orprinted on the cover tape 704 which in turn is affixed to the carriertape 700. This identifier or barcode 720 then functions to identify themedication which is contained in this carrier tape 700.

[0082] As depicted in FIGS. 15 and 16, the first and second ends 710,712, of the carrier tape 700 are releasibly attached to one another bymeans of the “snap-like” fit of the last pocket 716 into the firstpocket 714. Other methods of attaching the first and second ends 710,712 are envisioned such as the use of heat activated adhesive orpressure sensitive adhesive. By using adhesives, it would notnecessarily be required that the last pocket 712 to engage in the firstpocket 714.

[0083] As depicted in FIGS. 17, 18 and 19, the carrier tape 700 isplaced on a rotational member 722 which is then inserted into a housing724. The housing 724 has a base and cover 728 which is hinged to thebase 726. The rotational member 722 has teeth 730 and engages theratchet protrusions 732 on the base of 726 of the housing 724 when therotational member 722 is placed in the housing 724.

[0084] The cover 728 is moved to a closed position with the base 726 andforms the radial dispensing medication cartridge 734 which operates aspreviously described herein. That is, in general, the cover tape 704 isremoved from the carrier tape 700 after the carrier tape 700 has beenplaced on the rotational member 722 and inserted over the hub 736 andthe coffer 728 closed. The cover 728 has a wall 738 which retains thetablets in the pockets 702 of the carrier tape 700 after the cover tape704 has been removed.

[0085]FIG. 20 depicts a cartridge 734, the cover 728 having been placedin the closed position against the base 726. Referring now also to FIG.19, the cover tape 704 is pulled out of the opening 744 in the cartridge734. As the cover tape 704 is pulled, it is removed from the carriertape 700, and thereafter is wound around the outside of cartridge 734 asshown in FIG. 20. Various adhesives and various locations on the outeredge of the cartridge 734 and the cover tape 704 can be utilized foraffixing the cover tape 704 to the cartridge 734. After the cartridgetape 704 is affixed to the cartridge 734 shown in FIG. 20, the tabletsare contained in the pockets 702 of the carrier tape 700 by the wall 734of the cartridge 734. The cover tape 704 therefore also functions toseal the opening 744 in the cartridge 734 during shipment of thecartridge 734. The identification 720, or bar code, also appears now onthe cover tape 704 and therefore the medication contained within thecartridge 734 is readily identifiable.

[0086]FIG. 21 shows a detail of the location of one of the ratchetprotrusions 732 on the base 726. The ratchet protrusion 739 engages therotational member 722 as previously described.

[0087] A plurality of radially dispensing medication cartridges 734 areinstalled in a medical dispensing device 746 as depicted in FIG. 22a.FIG. 22b is a cross sectional view of the medical dispensing device 746which shows one of the cartridges 734 which contains the carrier tape700. An operating system, such as a solenoid 748, is linked by shaft 750to a ratchet mechanism 752 that engages the teeth 730 on the rotationalmember 722. In response to receive electrical signals, the solenoid 748activates the mechanism 752 to rotate the rotational member 722, therebyreleasing a predetermined number of tablets 718 from respective pockets702. These tablets 718 fall down a shoot 754 to an open area 756 wherethey can be retrieved by a patient or other personnel.

[0088] For proper operation of the medical dispensing device 746, thecarrier tape 700 must be in proper registration with the rotationalmember 722. This is effected by pins 731 on the rotational member 722 asdepicted in FIG. 17. In this embodiment, four sets of 2 pins 731 eachare placed 90 degrees apart around the circumference of the rotationalmember 722. (See FIG. 17) Pins 731 engage the apertures 706 in thecarrier tape 700. Alternatively, apertures 739 are formed in the bottomsides 733 of the pockets 702 in the carrier tape 700. These apertures739 would then engage pins 735 of the rotational member 722. This isdepicted in FIG. 23. A further alternative is to utilize the spaces 786between the pockets 702 for engagement with pins 738 on the rotationalmember 722. (See FIG. 24).

[0089]FIG. 5 illustrates in a flow chart the operation of the medicationdispensing device 746. FIG. 11 is a flow chart depicting the operationof filling the carrier tape 700 and inserting the carrier tape 700 intothe medical dispensing device 746 for dispensing medication to apatient.

[0090] In the most general terms of the present invention, FIG. 25depicts a flow chart of the inventive process wherein initially (step800) a prescription for medication is received, for example, by apharmacist. In the next step 802 a prescription is filled by taking apredetermined length of carrier tape, inserting medication tablets intopockets of the carrier tape and scaling the carrier tape with a covertape. In an embodiment as described above, a packet at one end of thecarrier tape is not filled. A barcode is attached to the filled carriertape to identify the medication contained therein. In a third step 804the filled carrier tape is then installed in the cartridge and the covertape 704 is removed from the carrier tape 700 and affixed to the outerperimeter of the cartridge 734. It is to be understood that the barcodescan contain additional information, or a plurality of different barcodesor identifiers can be applied to either or both of the carrier tapes andcartridges.

[0091] In step 806 the filled cartridge is then forwarded to thepatient, pharmacy, or other destination. As depicted in FIG. 26, thecartridge is installed in the dispenser in step 808. In step 810 thepatient is identified and the medication is identified for dispensing tothe patient. In step 812 the medication is dispensed into a holding areaand in step 814 the medical dispensing device monitors the holding areato determine if the pills have been retrieved by the patient.

[0092]FIGS. 10 and 11 show the details of the method depicted in generalin FIGS. 25 and 26.

[0093]FIG. 27 is a logic diagram depicting operation of the presentinvention for dispensing medication. In a first step 900 a pilldispensing apparatus is initialized. In the second step 902 a patient isidentified by the patient's bar code identification, which is read by abar code reader on the medication dispensing device.

[0094] In step 904, the patient identification is read by a bar codereader and in step 906 patient identification information which isstored in a storage device 908 is read. Step 910 compares the patientbar code identification with the stored patient identificationinformation. If no match occurs, then the patient identification barcode is read again in step 904. If a correspondence is found in step910, then the procedure for updating the patient's prescription isinitialized in step 912.

[0095] The stored patient prescription information is read in step 914from the stored patient prescription information in storage device 916.In step 918 a comparison is made to determine if the patient'sprescription information matches the updated prescription information.If this is not the case, then the updated patient prescriptioninformation is stored in storage 916 in step 922. Thereafter, thepatient prescription information is accessed in step 924 from the storedpatient information storage 916.

[0096] The process for dispensing medication is initialized in step 926.A recently dispensed medicine lookup table is accessed in step 928 fromthe table stored in 930. Step 932 compares the recently dispensedmedication that is received from the recently dispensing medicationlookup table to the present prescription information. If no matchoccurs, then individual medication prescription information issequentially accessed by step 934 in the data base 936. A pill bar codeon a cartridge of pills is then read in step 938 after which acomparison is made between the read pill type and the desired pill type(see step 940). If no match occurs, then the pill cartridge is indexedto place the next pill cartridge in position for reading by step 938(see step 942). When a match occurs, then the look up table is updatedin step 944.

[0097] When a comparison is made in step 132 of the recently dispensedmedication in the look up table to the current prescription information,then the medication dispensing device dispenses the pills into a holdingarea. (See step 946). In step 948 it is determined if the patient hasretrieved the pills from the holding area. If the patient has notretrieved the pills, then a predetermined period of time is specifiedfor waiting in step 950. After the time period has expired then anothercheck is made to determine if the patient has retrieved the pills fromthe holding area in step 952. If the pills have still not been received,then information is provided of an unsuccessful delivery of pills ofmedication (see step 954). When a patient has retrieved the pills, thenthis information is recorded in step 956 and the recently dispensedmedication look up table is cleared in step 958. In step 960 themedication dispensing device is placed into a power down mode.

[0098] It should be understood that the implementation of othervariations and modifications of the invention in its various aspectswill be apparent to those of ordinary skill in the art, and that theinvention is not limited by the specific embodiments described. Forexample, many different variations may be made to the carrier tape. Itis therefore contemplated to cover by the present invention, any and allmodifications, variations, or equivalents that fall within the spiritand scope of the basic underlying principles disclosed and claimedherein.

What is claimed is:
 1. A medication dispensing device, comprising: atablet carrier tape having a plurality of tablet pockets, each of thepockets having one opening; and the tablet carrier tape having first andsecond ends that are attached to one another.
 2. The medicationdispensing device of claim 1, wherein a tablet cover tape is removablyattached to the tablet carrier tape and positioned to cover the openingsof the pockets.
 3. The medication dispensing device of claim 2, whereinat least one of each of the tablet pockets, except for at least one offirst and last pockets, contains a respective tablet that is retainedtherein by the tablet cover tape.
 4. The medication dispensing device ofclaim 1, wherein the first and second ends have predetermined structuresthat are engageable with one another such that the first and second endsof the tablet carrier tape are releasable attachable to one another. 5.The medication dispensing device of claim 1, wherein a first pocket onthe first end of the carrier tape is engageable with a last pocket onthe second end of the carrier tape.
 6. The medication dispensing deviceof claim 1, wherein the tablet carrier tape has a registrationstructure.
 7. The medication dispensing device of claim 6, wherein eachof the pockets has at least one aperture in a side opposite the opening,and wherein the at least one aperture forms the registration structure.8. The medication dispensing device of claim 6, wherein the registrationstructure is a series of registration apertures in at least one edge ofthe tablet carrier tape.
 9. The medication dispensing device of claim 6,wherein the pockets on the tablet carrier tape are spaced apart bysubstantially equal separation areas, and wherein the separation areasform the registration structure.
 10. The medication dispensing device ofclaim 2, wherein the cover tape has machine readable medicationidentification data thereon.
 11. A medication dispensing device,comprising: a housing having a base and a cover; a tablet carrier tapehaving a plurality of tablet pockets, each of the pockets having oneopening, the tablet carrier tape having first and second ends that areattached to one another to form a loop; a tablet cover tape initiallyremovably attached to the tablet carrier tape and positioned to coverthe openings of the pockets and thereafter affixed to an outer perimeterof the housing; at least one of each of the tablet pockets, except forat least one of the first and last pockets, containing a respectivetablet that is retained therein by the tablet cover tape; and arotational member for positioning the tablet cover tape and having aplurality of actuation surfaces that are configured to engage anactuating device to rotationally advance the tablet carrier tape forradially releasing tablets of medication, the rotational member beingpositioned between the base and cover of the housing.
 12. The medicationdispensing device of claim 11, wherein the first and second ends havepredetermined structures that are engageable with one another such thatthe first and second ends of the tablet carrier tape are releasableattachable to one another.
 13. The medication dispensing device of claim11, wherein a first pocket on the first end of the carrier tape isengageable with a last pocket on the second end of the carrier tape. 14.The medication dispensing device of claim 9, wherein the tablet carriertape has a registration structure.
 15. The medication dispensing deviceof claim 14, wherein each of the pockets has at least one aperture in aside thereof opposite the opening and wherein the at least one aperturein the pockets forms the registration structure.
 16. The medicationdispensing device of claim 14, wherein the registration structure is aseries of registration apertures in at least one edge of the tabletcarrier tape.
 17. The medication dispensing device of claim 14, whereinthe pockets on the tablet carrier tape are spaced apart by substantiallyequal separation areas, and wherein the separation areas form theregistration structure.
 18. The medication dispensing device of claim14, wherein the tablet pockets are sized to hold a single tablet. 19.The medication dispensing device of claim 11, wherein the base has aslot and wherein at least a portion of the rotating member extendsthrough the slot to expose engageable surfaces to an actuating member.20. The medication dispensing device of claim 11, wherein the coverincludes a tablet retaining wall protruding from a surface thereof. 21.The medication dispensing device of claim 11, wherein, the devicefurther comprises an activation surface to facilitate manual radialdispensing of medication from the cartridge.
 22. The medicationdispensing device of claim 11, wherein the rotational member is a gearand wherein the actuation surfaces include teeth.
 23. The medicationdispensing device of claim 11, wherein the base includes a plurality ofratchet protrusions operatively engageable with the rotational member torestrict rotational movement to facilitate single dose radial dispensingof tablets.
 24. The medication dispensing device of claim 11 wherein atleast the cover tape has machine readable medication identification datathat is visible when the cover tape is attached to the carrier tape andwhen the cover tape is affixed to the cartridge.
 25. A method of fillinga tablet carrier tape, comprising the steps of: providing a carrier tapehaving a plurality of pockets, each of the pockets having one opening;filling at least one of the pockets of a predetermined length of thecarrier tape with tablets of the medications, leaving empty at least onepredetermined pocket of the plurality of pockets.
 26. The methodaccording to claim 25, wherein the method further comprises: sealing thecarrier tape with a cover tape having an identifier such that theopenings are covered; attaching a first end of the carrier tape to asecond end of the carrier tape to form a loop; installing the carriertape in a cartridge; removing the cover tape from the carrier tape andaffixing the cover tape to an outer perimeter of the cartridge; removingthe cover tape from the carrier tape, the cartridge retaining thetablets in respective pockets of the carrier tape, and installing thecartridge in a medication dispenser; identifying a patient anddetermining a medication to be dispensed and a number of tablets of themedication to be dispensed; selecting via the identifier a cartridgethat contains the determined medication; removing from the respectivecarrier tape the determined number of tablets of the determinedmedication, and moving the number of tablets to a predetermined area ofthe medication dispenser; and monitoring the predetermined area forremoval of the tablets.
 27. The method according to claim 25, whereinthe method further comprises: attaching a first end of the carrier tapeto a second end of the carrier tape such that a loop is formed with thecover tape on an outer side thereof.
 28. The method according to claim27, wherein in the step of filling the pockets, one of a first pocket onthe first end of the tape or a last pocket on a second end of the taperemains empty, and wherein the first pocket on the first end of the tapeengages the last pocket on the second end of the tape to thereby attachthe first and second ends together.
 29. The method according to claim27, wherein the first end of the tape is glued to the second end of thetape to thereby form the loop.
 30. The method according to claim 29,wherein the first and second ends are glued using one of a cold sealadhesive and a heat activated adhesive.
 31. The method according toclaim 29, wherein the first and second ends are glued using a pressuresensitive adhesive.
 32. The method according to claim 26, wherein in thestep of filling the carrier tape a predetermined pocket is left emptysuch that when the cover tape is removed from the carrier strip, thepredetermined pocket is in alignment with an opening in the cartridgefor removal of tablets from the pockets.
 33. The method according toclaim 32, wherein in the step of removing tablets from the carrier tape,the carrier tape is rotated such that a number of pockets equal to thenumber of tablets to be dispensed move past the opening in thecartridge, thereby releasing a number of tablets equal to the number oftablets to be dispensed.
 34. A method or filing a tablet carrier tapecomprising the steps of: providing a carrier tape having a plurality ofpockets, each of the pockets having one opening: filling at least one ofthe pockets of a predetermined length of the carrier tape with tabletsof the medication; sealing the carrier tape with a cover tape such thatthe openings of the pockets are covered; and attaching a first end ofthe carrier tape to a second end of the carrier tape such that a loop isformed with the cover tape on an outer side thereof.
 35. The methodaccording to claim 34, wherein in the step of filling the pockets, oneof a first pocket on the first end of the tape or a last pocket on asecond end of the tape remains empty, and wherein the first pocket onthe first end of the tape engages the last pocket on the second end ofthe tape to thereby attach the first and second ends together.
 36. Themethod according to claim 34, wherein the first end of the tape is gluedto the second end of the tape to thereby form the loop.
 37. The methodaccording to claim 36, wherein the first and second ends are glued usingone of a cold seal adhesive and a heat activated adhesive.
 38. Themethod according to claim 36, wherein the first and second ends areglued using a pressure sensitive adhesive.
 39. The medication dispensingdevice of claim 34, wherein the at least one of the carrier tape andcover tape has machine readable medication identification data.
 40. Amethod of dispensing medication, comprising the steps of: providing acarrier tape having a plurality of pockets, each of the pockets havingone opening; filling at least one of the pockets of a predeterminedlength of the carrier tape with tablets of the medication, leaving emptyat least one predetermined pocket of the plurality of pockets; sealingthe carrier tape with a cover tape having an identifier; attaching afirst end of the carrier tape to a second end of the carrier tape toform a loop; installing the carrier tape in a cartridge; the cover tapefrom the carrier tape and affixing the cover tape to an outer perimeterof the cartridge such that the identifier is readable, the cartridgeretaining the tablets in respective pockets of the carrier tape, andinstalling the cartridge in a medication dispenser; identifying apatient and determining a medication to be dispensed and a number oftablets of the medication to be dispensed; selecting via the identifiera cartridge that contains the determined medication; removing from therespective carrier tape the determined number of tablets of thedetermined medication, and moving the number of tablets to apredetermined area of the medication dispenser; and monitoring thepredetermined area for removal of the tablets.
 41. The method accordingto claim 40, wherein the method further comprises attaching a first endof the carrier tape to a second end of the carrier tape such that a loopis formed with the cover tape on an outer side thereof.
 42. The methodaccording to claim 41, wherein the step of filling the pockets, one of afirst pocket on the first end of the tape or a last pocket on a secondend of the tape remains empty, and wherein the first pocket on the firstend of the tape engages the last pocket on the second end of the tape tothereby attach the first and second ends together.
 43. The methodaccording to claim 41, wherein the first end of the tape is glued to thesecond end of the tape to thereby form the loop.
 44. The methodaccording to claim 43, wherein the first and second ends are glued usingone of a cold seal adhesive and a heat activated adhesive.
 45. Themethod according to claim 43, wherein the first and second ends areglued using a pressure sensitive adhesive.